Predictors of Change in Physical Function in Older Adults in Response to Long-Term, Structured Physical Activity: The LIFE Study.
Andrew S Layne, Fang-Chi Hsu, Steven N Blair and 11 others
PMID 27568165WHAT IT FOUND
Older adults who walked more at baseline showed greater improvement in walking speed and physical performance.
In the exercise group, more center attendance was also associated with better function. Older age, less activity, and lower baseline function were associated with poorer response.
Key findings
01Across the whole sample, a standard deviation increase in daily steps was associated with an 81% greater likelihood of a strong gait-speed response and an 85% greater likelihood of a strong SPPB response.
02In the PA arm, 36.0% of participants with at least 60% center-based attendance improved SPPB by more than 1 point, compared with 24.2% of participants with less than 60% attendance.
03Low baseline SPPB score, defined as below 8, was the strongest independent predictor of major mobility disability and persistent major mobility disability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The LIFE study was not designed to evaluate individual differences in response to physical activity, so these are associations from a secondary analysis. The physical activity program included walking, strength, flexibility, and balance training, and the analysis cannot separate the contribution of any single component. Results may not apply to older adults with very high or very low physical function. Some gait speed was measured over 80m instead of 400m for participants who could not complete the 400m test, likely overestimating gait speed for those participants. The authors used manual backward elimination for some model selection and say the results must be interpreted with caution. The analysis did not include biological data that might explain response variability.
The easy way to misread this
Do not read the attendance and walking-minute findings as proof that one exercise component caused improvement. The PA program included walking, strength, flexibility, and balance training, and the analysis measured associations, not a controlled comparison of individual components.